A Study Of The Relationship Between The Changes Of Th17Cells And Its Major Cytokines And The Curative Effect Of Glycyrrhizic In Psoriasis

Objective: To explore the effect of Th17cells and its major cytokines inthe immunologic mechanism of the glycyrrhizic treatment of psoriasis vulgaris.Methods:30patients with progressing psoriasis vulgaris were divided intotwo groups. Group I, including15patients, was treated with glycyrrhizincombined with antihistamines and topica, while the other15patients (the groupII) were just treated with antihistamines and topica. Twelve healthy volunteerswere as control. The psoriatic lesion area and severity index (PSAI) was used toevaluate the patients’ condition before and after the treatment. The peripheralblood was collected before and after3weeks of treatment. The flow cytometrymethod was used to detect the proportion of Th17cells, and some characteristicsof a microplate method for the detection of IL-17A, IL-22and IL-23of serumusing enzyme linked immunosorbent assay (ELISA) are described. The bloodpressure, hepatic and renal function and electrolytes were used to assess the security of glycyrrhizin.Results:1.The clinical curative effect and PASI score: the effective rate ofthe group I after3weeks treatment was66.67%and the group II was20%. Thedifference between the two groups was statistically significant (P<0.05). ThePASI score of group I and II after treatment was lower than before treatment,and the difference was statistically significant (P<0.05). The group I showed alarger decline compared to group II.2. The proportion of Th17cells in CD3+CD8-T cells: The proportion of theTh17cells in CD3+CD8-T cell in the group I and II before treatment wassignificantly higher than healthy controls (P<0.05); The proportion of group Iafter3weeks treatment had significantly decreasion than before treatment(P<0.05); There was no statistically significant (P>0.05) difference betweenbefore and after treatment in group II.3. The level of IL-17A, IL-22and IL-23in serum: The levels in patientsbefore treatment were significantly higher than controls, and the differenceshowed statistical significance (P<0.05); The levels of group I after3weekstreatment were significantly decreased, and the difference also showed statisticalsignificance (P<0.05); The difference in group II had no statistically significantdifference (P>0.05).4. The correlationship analysis of PASI score and the proportion of Th17cells, IL-17A, IL-22and IL-23: the expression level of Th17cells, IL-17A, IL-22, IL-23and the PASI score has positive correlationship before and aftertreatment in group I and II (P<0.05).5. The correlationship analysis of PASI score decline index and theexpression decreased levels of Th17cells, IL-17A, IL-22and IL-23: The levelsof Th17cells, IL-17A, IL-22, IL-23and the PASI score was positivelycorrelated in group I (P<0.05); there was no correlationship in group II beforeand after treatment.6. Side effects: only one person in group got a hypokalemia within3weeks,and returned to normal after oral potassium supplement.Conclusions:1.There was a positive correlationship between theexpression of Th17cells, IL-17A, IL-22and IL-23in venous blood and theseverity of psoriasis vulgaris, it was suggesting that the proportion of Th17cellsand the expression of IL-17A, IL-22and IL-23might be a potential target toevaluate the severity of psoriasis vulgaris.2. The proportion of Th17cells and the expression of IL-17A, IL-22and IL-23were decline obviously after treatment with glycyrrhizin in the psoriasis vulgaris,and the expression levels positively related with the decline index of PASI score,it was suggesting that disturbing the expression of Th17, IL-17A, IL-22andIL-23might be an important mechanisms in psoriasis vulgaris by the treatmentof glycyrrhizic.